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By Nancy Lapid, Health Science Editor

Hello Health Rounds readers! Today we feature two potentially important discoveries in oncology, one involving treatment for thyroid cancer and another that could help predict outcomes in patients with a hard-to-treat breast cancer. We also delve into the mysteries of the gut microbiome and its impact on blood cholesterol.

In breaking news, see these stories from our Reuters journalists: Russian military intelligence unit may be linked to ‘Havana syndrome’; Florida top court lets abortion rights ballot measure go to voters; South Korea’s Yoon urges doctors to end impasse over trainees; Texas, CDC say bird influenza detected in person exposed to dairy cattle; and FAA should not require pilots to disclose talk therapy.

Plus: Gene involved in cell shape offers clues on left-handedness; malaria vaccine rollout highlights value of renewable power for cold chains; US takes next step in Medicare drug price negotiations with pharma companies; and US menthol cigarettes ban delayed.

A minimally invasive procedure that uses heat to destroy tumors might be a viable alternative to surgery for patients with the most common type of thyroid cancer, a new study suggests. In the photo shown here, a patient undergoes robotic microwave ablation at the Royal Marsden hospital in London. Frank Augstein/Pool via REUTERS

The most common type of thyroid cancer is usually treated with surgery, but a minimally invasive procedure that uses heat to destroy tumors might be a viable alternative, a new study suggests.

The researchers reviewed data on 682 patients with two or more papillary cancers in the thyroid gland diagnosed between 2015 and 2021, including 229 patients treated with microwave ablation and 453 treated with surgery.

Five years later, the rates of those whose cancer had not begun to worsen – known as progression-free survival – were statistically similar, at 77.2% with microwave ablation vs 83.1% with surgery. However, the ablation procedure resulted in less blood loss, shorter incision length, and shorter procedure times and hospital stays, according to a report published on Tuesday in Radiology.

Permanent hoarseness and hypoparathyroidism developed only in the surgical group. Patients who undergo surgery for thyroid cancer also require lifelong hormone replacement therapy afterward.

The study was not a randomized trial, but the research team tried to identify similar patients to compare in the two groups.

The findings “challenge traditional treatment paradigms and open new avenues for less invasive management strategies,” study leader Dr. Ming-An Yu at China-Japan Friendship Hospital in Beijing, China said in a statement.

Women with a hard-to-treat type of breast cancer may fare better and live longer if their tumors contain high levels of certain immune cells called tumor-infiltrating lymphocytes (TILs), a long-term study has found.

So-called triple-negative breast cancer does not respond to drugs that target proteins on tumor cell surfaces. It grows rapidly and is more likely to have spread by the time it is diagnosed and more likely to recur than other breast cancers.

An international study published on Tuesday in JAMA suggests patients with early-stage, triple-negative breast cancers containing high levels of TILs have a lower risk of recurrence and better survival rates even when not treated with chemotherapy.

TILs can move from the bloodstream into a tumor, where they recognize and destroy cancer cells, researchers explained.

Currently, most patients with early-stage triple-negative breast cancer undergo chemotherapy, usually with multiple drugs that cause significant side effects.

For the new study, researchers tracked nearly 2,000 patients with small, early triple-negative tumors who had surgery with or without radiation but who did not receive chemotherapy. Five years later, 95% of those with high TIL levels were alive, compared to 82% of patients whose tumors had low TIL levels.

At an average follow-up of 18 years, each 10% higher TIL level was associated with a 10% improvement in the odds of recurrence-free survival and a 12% improvement in the odds of survival, according to the report.

Triple-negative tumors account for about 15% of all breast cancers and are more common in younger people and in racial and ethnic minorities, previous studies have shown.

Pathologists do not generally measure TILs in breast tumor samples, but the results of this study could change that, the authors said.

“The study’s findings may inspire future clinical trials to explore whether patients with a favorable prognosis (high TILs) can avoid intensive chemotherapy regimens,” study leader Dr. Roberto Leon-Ferre of the Mayo Clinic in Rochester, Minnesota said in a statement.

Some people have a type of bacteria in their intestines that eat cholesterol, helping to lower their levels and heart disease risk, researchers reported on Tuesday in Cell.

Studying more than 1,400 participants in the decades-long Framingham Heart Study, designed to detect risk factors for cardiovascular disease, the researchers discovered that Oscillibacter bacteria take up and metabolize cholesterol from their surroundings, and that people carrying higher levels of these microbes in their gut had lower levels of cholesterol.

The researchers used gene sequencing to identify bacteria in stool samples. They also measured metabolites, or molecules produced by the bacteria, to track the microbes’ activities. 

They found that people with several species of Oscillibacter bacteria had lower cholesterol levels in their blood than those who lacked the bacteria.

After growing the bacteria in test tubes, researchers discovered that the microbes converted cholesterol into intermediate products that can then be broken down by other bacteria and excreted from the body.

The team also identified the enzymes responsible for this biochemical conversion.

Another gut bacterial species, Eubacterium coprostanoligenes, also contributes to decreased cholesterol levels and might have a synergistic effect with Oscillibacter on cholesterol, the researchers also reported.

“Our work highlights the possibility that (cholesterol metabolism) may be modified by gut microbes,” study leader Chenhao Li of at the Broad Institute of MIT and Harvard in Cambridge, Massachusetts said in a statement.

“There are potentially a lot of new discoveries to be made that will bring us closer to a mechanistic understanding of how microbes interact with the host.”

This newsletter was edited by Bill Berkrot. Additional reporting by Shawana Alleyne-Morris.

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